Corticosteroid injections for shoulder pain

Abstract

Despite many RCTs of corticosteroid injections for shoulder pain, their small sample sizes, variable methodological quality and heterogeneity means that there is little overall evidence to guide treatment. Subacromial corticosteroid injection for rotator cuff disease and intra-articular injection for adhesive capsulitis may be beneficial although their effect may be small and not well-maintained. There is a need for further trials investigating the efficacy of corticosteroid injections for shoulder pain. Other important issues that remain to be clarified include whether the accuracy of needle placement, anatomical site, frequency, dose and type of corticosteroid influences efficacy.

Ultrasound guided intra-articular ketorolac versus corticosteroid injection in osteoarthritis of the hip: a retrospective comparative study

“…In addition, a few clinical studies have directly compared local injection of a corticosteroid with systemic NSAIDs, but the current literature does not conclusively provide evidence to support that one treatment is better than the other [42]. The Cochrane Collaboration's systematic review concluded that although there is evidence in support of corticosteroid injections, the effect may be no better than with systemic NSAIDs [42,44].…”

Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial

“…[44][45][46] Analgesic benefits of intra-articular injection of corticosteroids in rheumatoid arthritis may be more sustained (up to 3 months). 47 Drawing on these data from other parts of the musculoskeletal system, it is a reasonable hypothesis that intra-articular injection of corticosteroids could produce at least short-term pain relief in a different synovial joint that is causing pain.…”

Ultrasound-guided interventional procedures around the shoulder

“…43 Ultrasound-guided steroid injection may be considered in primary/secondary adhesive capsulitis with associated degenerative osteoarthritis and articular effusion. 44 This treatment showed improvement in clinical outcome, both in terms of pain reduction and increased mobility. 45 Another possibility is to obtain a capsular distension with lidocaine and hyaluronic acid; according to Park et al, 46 this option is as effective as steroid injection in pain relief and functional improvement.…”